close

Вход

Забыли?

вход по аккаунту

?

jsr.2017-0173

код для вставкиСкачать
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
Note: This article will be published in a forthcoming issue of
the Journal of Sport Rehabilitation. The article appears here in
its accepted, peer-reviewed form, as it was provided by the
submitting author. It has not been copyedited, proofed, or
formatted by the publisher.
Section: Original Research Report
Article Title: Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing
Intramuscular and Skin Temperature
Authors: Jennifer Ostrowski
Affiliations: Sports Medicine & Rehabilitation, Moravian College, Bethlehem, PA.
Running Head: Salted ice vs cryo-compression
Journal: Journal of Sport Rehabilitation
Acceptance Date: September 19, 2017
©2017 Human Kinetics, Inc.
DOI: https://doi.org/10.1123/jsr.2017-0173
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and
Skin Temperature
Jennifer Ostrowski, PhD, LAT, ATC
Moravian College
Sports Medicine & Rehabilitation Center, Room 235
1441 Schoenersville Road
Bethlehem, PA 18018
610-625-7203
ostrowskij@moravian.edu
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
Abstract
Context: Rest, ice, compression, and elevation are commonly recommended immediately postinjury. Traditionally, ice bag with elastic wrap compression has been utilized, however recently
intermittent cryo-compression units are being used.
Limited research has evaluated tissue
temperature decreases with intermittent cryo-compression units. Objective: Evaluate magnitude
of muscle and skin cooling. Design: Repeated-measures counterbalanced study. Setting:
University research laboratory. Patients or Other Participants: 12 healthy college-aged
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
participants
(4
males,
8
females,
age=23.08±1.93
years,
height=171.66±9.47
cm,
mass=73.67±13.46kg, subcutaneous thickness=0.90±0.35 cm) without compromised circulation
or injury. Intervention(s): Salted ice bag, GameReady (GR), and PowerPlay-ice (PP-ice) were
applied to the posterior-aspect of the non-dominant calf for 30-minutes; participants underwent
each treatment in counterbalanced order. Main Outcome Measure(s): Muscle temperature
measured via 21-gauge catheter thermocouple, skin temperature measured via surface
thermocouple. Temperatures were recorded at baseline and during a 30-minute treatment.
Correlations were evaluated between muscle and skin temperatures. Results: Non-significant
treatment-by-time interaction and non-significant main effect of treatment for intramuscular
cooling. Mean decrease from baseline: IB: 6.4°C ( 2.8), GR: 5.4°C (1.1), PP-ice: 4.8°C (2.8).
Non-significant treatment-by-time interaction for skin cooling (F(20,200)=1.440, p=0.648, partial
eta2=0.346, observed = 0.773), but significant main effect for treatment (F(10,100)=5.279, p=0.029,
partial eta2=0.883, observed = 1.00). Mean decrease from baseline: IB: 17.0°C, GR: 16.4°C,
14.6°C. No significant correlation between intramuscular and skin temperatures in any condition
at any time point. No significant correlation between adipose tissue thickness and maximum
temperature decrease with any modality.
Conclusions: Salted ice bag with elastic wrap
compression, GameReady, and PowerPlay-ice produced equivalent intramuscular temperature
decreases during the treatment period.
Key Words: cryotherapy, GameReady, PowerPlay
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
Introduction
Cryotherapy is one of the most commonly utilized modalities during immediate care of
athletic injuries and is often included as part of RICE (rest, ice, compression, elevation), however
evidence supporting these components as a whole or individually is incluclusive.1 Physiologic
effects of cryotherapy include decreased metabolism,2,3 vasoconstriction and decreased vascular
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
permeability,4–6 and decreased conduction velocity of sensory afferent fibers7,8 and muscle
mechanoreceptors.9 These physiologic effects have been proposed to limit secondary tissue
death,10–13 limit edema formation,5 and decrease pain.8,14 Previous research has found wetted ice
bags and salted ice bags are able to produce greater intramuscular temperature decreases than
traditional cubed and crushed ice bags.15,16
Studies examining cooling magnitude of cryotherapy modalities often measure skin
temperature, versus muscle temperature.17–21 However, heat transfer through conduction (as is
elicited with cryotherapy modalities) suggests that temperature of superficial tissue will always
decrease more than deeper tissue,22,23 therefore extrapolations about muscle temperature decreases
based on skin temperature decreases are inappropriate. Some previous studies examining muscle
temperature decreases with cryotherapy modalities have also measured skin temperature, and have
found no significant correlation between muscle and skin temperatures.16,19,24
The use of constant external compression is also recommended during the immediate care
phase,10,25 as it serves both to increase tissue temperature decreases and further prevent edema
formation. Elastic wraps are the preferred compression method, with research showing elastic
wrap compression produces greater temperature decreases than flexi-wrap compression,21,25 and
than Cryo/Cuff or Dura*Kold.21 Clinically, cryo-compression modalities that utilize intermittent
compression are commonly used in early stages of injury, however intermittent compression units
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
are designed to aid in edema removal versus edema prevention26 and may not produce the same
intramuscular temperature decreases as cryotherapy applied with constant compression. Only one
previous study has evaluated crushed ice bag with elastic wrap compression compared to
GameReady,27 and no previous studies have compared salted ice bags with elastic wrap
compression to commonly-used intermittent cryo-compression units (i.e., GameReady,
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
PowerPlay). Due to the desired physiologic effects of cryotherapy and compression during the
immediate care phase, it is of interest examine the impact on tissue temperature when cryotherapy
is combined with intermittent versus constant compression.
The purpose of this study was therefore to compare salted ice bag with elastic wrap
compression, GameReady intermittent compression, and PowerPlay (wetted ice bag condition)
intermittent compression, on intramuscular and skin temperatures. Correlations were evaluated
between muscle and skin temperature, and between adipose tissue thickness and maximum
temperature decrease.
Methods
Design
The study was a repeated-measures, cross-over design where each subject received each
treatment condition in a counterbalanced order: salted ice bag (IB) with elastic wrap compression
at 50mmHg of pressure, GameReady (GR) on high compression setting (15-75mmHg),
PowerPlay-Ice Bag (PP-ice) at 70mmHg of compression. The subjects were assigned to their
treatment order based on a predetermined order scheme (ABC, ACB, BAC, BCA, CAB, CBA).
Treatment conditions were separated by a minimum of 4 days and a maximum of 7 days to ensure
there were no carryover effects. The two independent variables were treatment time and condition
(IB, GR, PP-ice). The dependent variables were intramuscular temperature and skin temperature.
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
Participants
Twelve healthy participants (4 males, 8 females, age=23.1±1.9 years, height=171.7±9.5
cm, mass=73.7±13.5kg, subcutaneous thickness=0.9±0.4 cm) aged 18-26 were recruited (a priori
power analysis conducted using G*Power; calculated using desired effect size=0.4, p=0.05,
desired power=0.80). Subjects were excluded if they had a history of vascular disease,
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
compromised circulation or sensation in the lower leg, leg injury within the past 6 months, were
regularly taking anti-inflammatory medication or fish oil (3 or more times per week) or had any
known contraindications to cryotherapy. Subjects were instructed to refrain from exercise prior to
each treatment session. All subjects provided informed consent, and subject rights were protected
to the fullest extent of the law. This study was approved by the Institutional Review Board. All
subjects read and signed an informed consent form.
Procedures
The triceps surae group on the non-dominant leg (defined as stance leg when kicking a
soccer ball) was identified as the treatment leg. The area of largest girth was measured for the
location of thermocouple insertion. The amount of subcutaneous adipose tissue was measured via
musculoskeletal ultrasound (GE logiq e, Wauwatosa, WI) using a 12L linear array probe that was
held perpendicular to the posterior surface of the calf. Adipose thickness was measured to the top
of the fascial line, and was recorded on the data collection sheet; 2cm was added to the amount of
adipose tissue, and this number was recorded on the data collection sheet as the desired depth of
thermocouple insertion. Insertion depth was controlled by marking the medial aspect of the calf
the appropriate vertical distance (2cm+adipose thickness) from the posterior surface of the lower
leg, then inserting the thermocouple parallel to the frontal plane (see Figure 1). The area of
insertion was sanitized using 10% povidone-iodine followed by a 70% isopropyl alcohol swab.
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
The investigator then inserted the thermocouple at the desired depth; this depth was verified using
the musculoskeletal ultrasound unit with an acceptable margin of error of 3mm across all 3
treatment conditions. Once depth was verified, the surface thermocouple was attached to the
posterior calf at the area of largest girth.
Intramuscular temperature was measured via 21-gauge, 1-in catheter thermocouple (IT-21,
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
Physitemp Instruments, Inc, Clifton, NJ) with an extension cord. Skin temperature was measured
using a surface thermocouple (SST-1, Phsyitemp Instruments, Inc, NJ). Both thermocouples were
plugged into an electrothermometer (Iso-Thermex; Columnus Instruments, Columbus, OH).
Validity and reliability of IT-21 thermocouples have been studied previously and it has been
recommended that researchers test and report on the equipment utilized in the study.28,29 The three
intramuscular thermocouples utilized in the study were pilot tested with the Iso-Thermex
electrothermometer and a calibrated mercury thermometer; thermocouples were found to be valid
as compared to the mercury thermometer and reliable within 0.08C. Previous research has
demonstrated that the use of an extension cord does not influence temperature measurement.30
Treatment conditions were not applied until intramuscular temperatures had plateaued (no change
in temperature of more than 0.1C for three consecutive readings). The treatment condition was
then applied to the posterior aspect of the calf.
Salted ice bag was made with 2000mL cubed ice and ½ tablespoon salt and secured with
elastic compression maintained at 50mmHg (pressure was accessed using a pressure gauge during
pilot testing; consistent pressure at 50mmHg was applied). GameReady intermittent compression
was applied using the knee sleeve (Figure 2), and the unit was filled with 3500 mL of cubed ice
and 2000 mL of water. Pressure was set to “high” setting (the “high” pressure setting has an
unmodifiable pressure range of 5-75mmHg), during which the sleeve undergoes cycles of 3-minute
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
inflation and 1-minute deflation during the entire treatment time. The PowerPlay intermittent
compression can be applied with either a gel pack insert, or wetted ice bag inserts. Previous
research has found that the wetted ice bag inserts produce greater magnitude of cooling than gel
packs,31 therefore the wetted ice bag inserts were utilized in this study. The PowerPlay was applied
using the 360-knee sleeve (Figure 3) with ice-bag insert option (Figure 4; two ice bag inserts each
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
filled with 1500mL cubed ice and 150mL water). Pressure was set to 70mmHg, with unmodifiable
inflation cycles of 20-second inflation, 10-second hold, and 20-second deflation during the
treatment time. After the treatment period, the modality was removed, and the surface
thermocouple was removed and cleaned with 70% isopropyl alcohol. The intramuscular
thermocouple was removed and the insertion area was cleaned with 70% isopropyl alcohol and
covered with single antibiotic ointment and a self-adhesive bandage.
The intramuscular
thermocouple was cleansed with a mild protein-dissolving detergent (Enzol; Johnson & Johnson,
Irvine, CA), followed by high-level disinfection by placing it in 1.5% glyderaldehyde (MetriCide;
Metrex Research, Romulus, MI) for a minimum of 12 hours.
Statistical Analysis
A mixed-model analysis of variance with repeated measures was calculated for each
dependent variable (intramuscular cooling, skin cooling). We conducted a 3x6 analysis for muscle
and skin cooling (temperatures at 6-minute intervals were utilized so that the number of levels in
the repeated measures was less than the number of subjects; this is required to generate output for
Mauchley’s test of Sphericity). Pairwise comparisons were examined in the presence of significant
main effects; post hoc testing used the Bonferroni correction. Pearson correlation coefficients
between intramuscular and skin temperature decreases were calculated (a priori), and correlations
between subcutaneous adipose thickness and maximum muscle temperature decreases were
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
calculated (post-hoc). All statistics were two-tailed with the level set a priori at 0.05 (SPSS
version 21; SPSS Inc., Chicago, IL).
Results
For intramuscular cooling there was no significant treatment-by-time interaction
(F(20,220)=1.443, p=0.104, partial eta2=0.116, observed = 0.911) or main effect for treatment
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
(F(2,22)=0.527, p=0.598, partial eta2=0.046, observed = 0.126). There was a significant main
effect for time (F(10,110)=83.169, p<0.001, partial eta2=0.883, observed = 1.00); intramuscular
temperatures decreased at each time point (Figure 5). Mean intramuscular temperatures are
reported in Table 1. For skin cooling, there was a non-significant treatment-by-time interaction
(F(20,200)=1.440, p=0.648, partial eta2=0.346, observed = 0.773), but significant main effects for
treatment (F(10,100)=5.279, p=0.029, partial eta2=0.883, observed = 1.00) and time
(F(10,110)=852.206, p<0.001, partial eta2=0.985, observed = 1.00). Mean skin temperatures are
reported in Table 2. Pairwise comparisons with Bonferroni correction indicated that salted ice bag
cooled significantly more than GameReady (p=0.037) and PowerPlay-Ice (p=0.039); there was no
difference between GameReady and PowerPlay-Ice (p=0.640). Pairwise comparisons for time
indicated that skin temperature decreased at each time point (Figure 6).
Correlations were evaluated between skin and intramuscular temperature in each of the
conditions (salted ice bag, GameReady, PowerPlay-ice) during cooling. There were no significant
correlations between these intramuscular and skin temperatures in any condition at any time point.
Correlations were also evaluated between subcutaneous adipose thickness and maximum muscle
temperature decrease for each of the conditions; there were no significant correlations between
adipose thickness and any of the three conditions.
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
Discussion
There were no statistically significant differences in intramuscular cooling between salted
ice bag with constant compression, GameReady intermittent compression, and PowerPlay-ice
intermittent compression.
Intramuscular temperature decreased significantly for all three
modalities, and without an established therapeutic range for cryotherapy (as exists for
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
thermotherapy) it cannot be stated that any of the modalities evaluated in this study produced
superior cooling related to another at a depth of 2cm subadipose.
While differences in
intramuscular temperatures across the modalities were non-significant, the small differences in
temperature decreases may be partially explained by the different ice-to-water ratios across the
three modalities. We selected the ratios we did based on the previous research with salted ice bag
(2000mL cubed ice, no water)16 and based on manufacturer fill lines for the GameReady ice and
water chamber (standardized to 3500 mL of cubed ice, 2000 mL of water) and PowerPlay ice bags
(standardized to 1500mL cubed ice, 150mL water); this was intentional in order to test the
modalities in the way that they are being used in clinical practice. It is possible that standardizing
the ratio of ice to water across the three modalities may have produced different results.
Salted and wetted ice bag have previously been identified as able to produce greater
intramuscular temperatures than traditional cubed or crushed ice,15,16,32 and our study produced
greater temperature decreases with our salted ice bag than these previous studies (6.39C, versus
4.46C with Wet-Ice,32 4.7C with salted ice,16 and 4.8C with wetted ice15), likely due to the
addition of the elastic compression. The type of compression (intermittent versus constant) may
be a consideration when the threat of edema formation is present, as constant compression is still
recommended for edema prevention.25,33–35 Results of previous research comparing intramuscular
temperature using crushed ice bag with elastic wrap to GameReady under three pressure conditions
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
(high, medium, no compression) found that the ice bag with elastic wrap resulted in significantly
greater intramuscular cooling than GameReady.27 Our study found a lesser magnitude of
temperature decrease than this previous study, which reported average intramuscular temperature
decreases from baseline of 13.4°C with ice bag and 10.6°C with GameReady on high pressure.
This may be partially explained by the fact that the previous study measured intramuscular
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
temperature at 1.5cm subadipose while we measured 2cm subadipose. Additionally, desired depth
in this previous study was calculated by performing a skinfold measurement and then adding
1.5cm, but the actual depth of thermocouple placement was not verified. In our study, we
measured uncompressed subcutaneous fat using musculoskeletal ultrasound which has been found
to be valid and reliable and to be more accurate than skin fold measurement,36,37 and thermocouple
placement was also verified via musculoskeletal ultrasound with care taken to ensure that all
placement depths were within a 3mm error range.
Skin temperature decreases across all three modalities were very similar, however salted
ice bag resulted in the greatest decrease from baseline. Previous research has suggested that skin
temperature below 13.6°C is needed to induce localized analgesia, below 12.5°C to reduce nerve
conduction velocity, and between 10-11°C to lower metabolic enzyme activity by 50%.17 Other
research has found that for every 1°C decrease in skin temperature, nerve conduction velocity
decreases by approximately 0.4 m/sec.8 Based on skin temperature results from our study, both
salted ice bag (11.2°C) with elastic compression and GameReady (13.1°C) decreased skin
temperature to the range to induce analgesia (13.6°C), and salted ice bag decreased skin
temperature to the range to decrease nerve conduction velocity (12.5°C), both of which would
serve to decrease pain and potentially allow for increased pain-free activity (ie, cryokinetics)
during the post-immediate care phase. In our study, salted ice bag with elastic compression was
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
the only modality that decreased average skin temperature to the range where metabolic activity is
decreased by 50%; this may further support the use of salted ice bag with elastic compression
during the immediate care phase of injury when the threat of secondary metabolic injury and edema
formation are present. However, skin temperature is highly variable, and skin temperature
decreases are much larger than intramuscular temperature decreases. Correlations in this study as
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
well as previous studies16,19,24 have demonstrated no significant relationship between skin and
muscle temperatures, indicating that skin temperatures cannot be utilized to approximate muscle
temperature decreases.
It should be noted that a perceived limitation of this study is that we did not adjust treatment
times based on each participant’s subcutaneous adipose thickness. One previous study suggested
that subcutaneous adipose tissue thickness alters cooling time during cryotherapy, with individuals
with thicker adipose tissue taking longer to reach maximal cooling.22 Other studies recommend a
minimum of 30 minutes of cryotherapy application during the immediate care phase in order to
induce maximal tissue temperature decreases and to prolong the rewarming process.16,38 We chose
to standardize treatment time in our study to 30 minutes, regardless of measured adipose thickness.
We did this as we felt this was more clinically applicable (adipose thickness is not typically
measured in a clinical setting). Additionally, we felt the counterbalanced study design, where each
subject underwent each treatment condition, controlled for any differences in maximum cooling
based on adipose thickness. In order to retrospectively justify this decision, we evaluated
correlations between subcutaneous adipose thickness and maximum muscle temperature cooling
in each of the three conditions (salted ice bag, GameReady, PowerPlay) and found none of these
correlations to be significant. We also chose not to standardize the amount of ice and water across
the three modalities, but rather to evaluate cooling as the modalities are applied in clinical practice.
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
Future research could consider standardizing the amount of ice and water in each modality and
reexamining muscle temperature decreases elicited. A final limitation of this study was that actual
pressure applied by each modality was not measured in real-time during the treatment period, and
differences in pressure may have influenced the magnitude of cooling.
Conclusions
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
Salted ice bag, GameReady, and PowerPlay-ice produced similar intramuscular
temperature decreases, however only Salted Ice Bag and GameReady were capable of decreasing
skin temperature to levels that produce desirable physiologic effects, including decreased nerve
conduction velocity and decreased pain. During the immediate care phase, where goals of
cryotherapy also include limiting edema formation, use of salted ice bag with elastic compression
may be more desirable than intermittent compression, and future research should focus on
differences in these three modalities’ abilities to prevent edema formation.
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
References
1.
van den Bekerom M, Struijs P, Blankevoort L, Welling L, van Dijk C, Kerkhoffs G.
What is the evidence for rest, ice, compression, and elevation therapy in teh treatment of
ankle sprains in adults? J Athl Train. 2012;47(4):435-443.
2.
Seiyama A, Shiga T, Maeda N. Temperature effect o oxygenation and metabolism of
perfused rat hindlimb muscle. Adv Exp Med Biol. 1990;277:541-547.
3.
Abramson D, Kahn A, Tuck S, Turman G, Rejal H, Fleischer C. Relationship between a
range of tissue temperature and local oxygen uptake in the human forearm. Lab Clin
Med. 1957;50:789-793.
4.
Gregson W, Black M, Jones H, et al. Influence of cold water immersion on limb and
cutaneous blood flow at rest. Am J Sports Med. 2011;39(6):1316-1323.
5.
Deal D, Tipton J, Rosencrance E, Curl W, Smith T. Ice reduces edema. A study of
microvascular permeability in rats. J Bone Jt Surg Am. 2002;84A(9):1573-1578.
6.
Schwartz D, Kaplin K, Schwartz S. Hemostasis, surgical bleeding, and transfusion. In:
Principles of Surgery. Vol 8. 2nd ed. New York: McGraw-Hill Book Co; 2005.
7.
Knight K. In: Cryotherapy in Sport Injury Management. Champaign, IL: Human
Kinetics; 1995:301.
8.
Algafly A, George K. The effect of cryotherapy on nerve conduction velocity, pain
threshold and pain tolerance. Br J Sports Med. 2007;41(6):365-369.
9.
Eldred E, Lindsley D, Buchwald J. The effect of cooling on mammalian muscle spindles.
Exp Neurol. 2:144-157.
10.
Knight K, Draper D. Therapeutic Modalities: The Art and Science. 2nd ed. Lippincott
Williams & Wilkins
11.
Merrick M. Secondary injury after musculoskeletal trauma: A review and update. J Athl
Train. 2002;37(2):209-217.
12.
Kehrer J. Free radicals as mediators of tissue injury and diseases. Rev Toxicol.
1993;23(1):21-43.
13.
Oliveira N, Rainero E, Salvini T. Three intermittent sessions of cryotherapy reduce the
secondary muscle injury in skeletal muscle of rat. J Sport Sci Med. 2006;5:228-234.
14.
Long B, Knight K, Hopkins T, Parcell A, Feland J. Production of consistent pain by
intermittent infusion of sterile 5% hypertonic saline, followed by decrease of pain with
cryotherapy. J Sport Rehabil. 2012;21(3):225-230.
15.
Dykstra J, Hill H, Miller M, Cheatham C, Michael T, Baker R. Comparisons of cubed
ice, crushed ice, and wetted ice on intramuscular and surface temperature changes. J Athl
Train. 2009;44(2):136-141.
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
16.
Hunter E, Ostrowski J, Donahue M, Crowley C, Herzog V. Effect of salted ice bags on
surface and intramuscular tissue cooling and rewarming rates. J Sport Rehabil.
2016;25(1):70-76.
17.
Chesterton L, Foster N, Ross L, Dip G. Skin temperature response to cryotherapy. Arch
Phys Med Rehabil. 2002;83(4):543-549.
18.
Kennet J, Hardaker N, Hobbs S, Selfe J. Cooling efficiency of 4 common cryotherapeutic
agents. J Athl Train. 2007;42(3):343-348.
19.
Hawkins J, Shurtz J, Spears C. Traditional cryotherapy treatments are more effective than
Game Ready on medium setting at decreasing sinus tarsi tissue temperatures in uninjured
subjects. J Athl Enhanc. 2012;1(2):1-5.
20.
Burke J, Herman A, Long B, Miller K. Ankle skin temperature changes following ice bag
application with compression at varying levels of elevation. Athl Train Sports Health
Care. 2017;9(4):163-168.
21.
Danielson R, Jaeger J, Rippetoe J. Differences in skin surface temperature and pressure
during the application of various cold and compression devices. J Athl Train.
1997;32(S):76.
22.
Otte J, Merrick M, Ingersoll C, Cordova M. Subcutaneous adipose tissue thickness alters
cooling time during cryotherapy. Phys Med Rehabil. 2002;83(11):1501-1505.
23.
Petrofsky J, Laymon M. Heat transfer to deep tissue: the effect of body fat and heating
modality. J Med Eng Technol. 2009;33(5):337-348.
24.
Enwemeka C, Allen C, Avila P, Bina J, Konrade J, Munns S. Soft tissue thermodynamics
before, during, and after cold pack therapy. Med Sci Sports Exerc. 2002;34(1):45-50.
25.
Tomchuk D, Rubley M, Holcomb W, Guadagnoli M, Tarno J. The magnitude of tissue
cooling during cryotherapy with varied typed of compression. J Athl Train.
2010;45(3):230-237.
26.
Mora S, Zalavras C, Wang L, Thordarson D. The role of pulsatile cold compression in
edema resoluation following ankle fractures: a randomized clinical trial. Foot Ankle Int.
2002;23(11):999-1002.
27.
Holwerda S, Trowbridge C, Womochel K, Keller D. Effects of cold modality application
with static and intermittent pneumatic compression on tissue temperature and systemic
cardiovascular responses. Sports Health. 5(1):27-33.
28.
Jutte L, Knight K, Long B. Reliability and validity of electrothermometers and associated
thermocouples. J Sport Rehabil. 2008;17(1):50-59.
29.
Long B, Jutte L, Knight K. Response of thermocouples interfaced to electrothermometers
when immersed in 5 water bath temperatures. J Athl Train. 2010;45(4):338-343.
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
30.
Jutte L, Long B, Knight K. Temperature measurement reliability and validity with
thermocouple extension leads or changing lead temperature. J Athl Train. 45(6):642-644.
31.
Ostrowski J, Purchio A, Bartoletti M, Leisinger J, Tucker M, Hurst S. Examination of
intramuscular and skin temperature decreases produced by the PowerPlay intermittent
compression cryotherapy. J Sport Rehabil Press.
32.
Merrick M, Jutte L, Smith M. Cold modalities with different thermotynamic properties
produce different surface and intramuscular temperatures. J Athl Train. 2003;38(1):2833.
33.
Wilkerson G. Management of the acute inflammatory response following joint trauma.
Sports Med Update. 1992;7(3):12-15, 28.
34.
Wilkerson G. Treatment of ankle sprains with external compression and early
mobilization. Physician Sportsmed. 1985;13(6):83-90.
35.
Merrick M, Knight K, Ingersoll C, Potteiger J. The effects of ice and compression wraps
on intramuscular temperatures at various depths. J Athl Train. 1993;28(3):236-245.
36.
Muller W, Horn M, Furhapter-Rieger A, et al. Body composition in sport: a comparison
of a novel ultrasound imaging technique to measure subcutaneous fat tissue compared
with skinfold measurement. Br J Sports Med. 2013;47:1028-1035.
37.
Selkow N, Day C, Liu Z, Hart J, Hertel J, Saliba S. Microvascular perfusion and
intramuscular temperature of the calf during cooling. Med Sci Sports Exerc. 44(5):850856.
38.
Mlynarczyk J. Skin temperature changes in the ankle during and after ice pack
application of 10, 20, 30, 45, and 60 minutes. Masters Thesis, Indiana State University,
Terre Haut, IN, 1984.
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
Figure 1. Thermocouple Insertion
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
Figure 2. GameReady Knee Sleeve Applied to Calf
Figure 3. PowerPlay Knee Sleeve Applied to Calf
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
Figure 4. PowerPlay with Ice Bag inserts (top: ice bags, bottom: ice bags in pouch units)
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
Figure 5. Intramuscular Cooling
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
Figure 6. Skin Cooling
“Effectiveness of Salted Ice Bag Versus Cryo-Compression on Decreasing Intramuscular and Skin Temperature” by Ostrowski J
Journal of Sport Rehabilitation
© 2017 Human Kinetics, Inc.
Table 1. Average Intramuscular Temperatures During 30-Minute Cooling Period, Mean (
standard deviation)
Downloaded by Australian Catholic University on 10/25/17, Volume 0, Article Number 0
Salted
Ice Bag
Game
Ready
Power
Play Ice
Baseline
36.3C
(1.0)
36.2C
(1.0)
36.2C
(1.0)
Minute 6
35.9C
(1.1)
35.8C
(1.1)
35.9C
(1.0)
Minute 12
34.6C
(1.8)
34.9C
(1.8)
35.0C
(1.5)
Minute 18
33.0C
(2.4)
33.6C
(2.6)
33.7C
(2.2)
Minute 24
31.3C
(2.9)
32.2C
(2.9)
32.5C
(2.6)
Minute 30
29.9C
(3.1)
30.8C
(3.3)
31.4C
(2.9)
Change
6.4°C
( 2.8)
5.4°C
(1.1)
4.8°C
(2.8)
Table 2. Average Skin Temperatures During 30-Minute Cooling Period, Mean ( standard
deviation)
Salted Ice
Bag
Game
Ready
Power
Play Ice
Baseline
28.2C
(2.0)
29.5C
(1.8)
29.7C
(1.5)
Minute 6
19.6C
(2.7)
21.8C
(1.5)
23.0C
(3.6)
Minute 12
15.7C
(3.1)
17.7C
(1.6)
19.4C
(4.6)
Minute 18
13.4C
(3.2)
15.5C
(1.5)
17.3C
(4.8)
Minute 24
12.1C
(3.0)
14.1C
(1.4)
15.9C
(4.8)
Minute 30
11.2C
(2.6)
13.1C
(1.3)
15.1C
(4.8)
Change
17.0°C
(3.1)
16.4°C
(1.5)
14.6°C
(4.8)
Документ
Категория
Без категории
Просмотров
1
Размер файла
557 Кб
Теги
2017, jsr, 0173
1/--страниц
Пожаловаться на содержимое документа